In this article, I will be focusing on the healthcare systems and standards of the UK and the US with a slight focus on what the recent elections will mean for both nations.
The UK healthcare is primarily the NHS (national health service) which has been in effect since 1948 with its main goal to give a fair and accessible service to all. However, following increased pressure over the last decade or so more and more of UK healthcare is becoming privatised. This can be more easily understood by looking into the structure of the NHS, according to the NHS themselves it is not a single entity rather an umbrella organisation comprised of hundreds of different organisations of differing sizes, national, regional and local levels with different roles and responsibilities. It is funded by taxation and aims to ensure minimal and no out of pocket costs.
This is significantly different to in the US as the American healthcare system isn’t funded by taxation rather being provided by a mix of private (the most dominant) and public insurers, government programs (Medicare/Medicaid) or by employer-based coverage. This in turn leads to prices of care hiking and healthcare between organisations to be difficult as they have their own systems and management. Due to lack of an overarching link between these independent body referrals and quality is very dependent on the type of healthcare system you are in.
As previously mentioned, the healthcare system in the UK aims to be as accessible as possible with as little as possible out of pocket fees being incurred by service users, this service is generally much lower than the US with many exemptions being given under specific circumstances e.g. age (under 18 or over 60), educational status (full time education), jobseekers, people in receipt of child-tax credits, individuals receiving universal credit amongst other things.
In the US due to the privatised nature of the healthcare system costs are generally considerably higher and are largely out of pocket and reliant on the state of the insurance of the individual. However, there is a service similar to what the NHS provides for the elderly called Medicare and for those experiencing financial strain Medicaid is the service responsible for aiding them in paying for their medical expenses. Both these services were established by President Lyndon Johnson in 1965 with the intention of helping Americans and their healthcare. It was initially brought in as a basic insurance program for Americans who didn’t/couldn’t afford healthcare but has since expanded to help more and more and have a larger overarching help by widening requirements. Despite these efforts healthcare expenses in the US are still exponentially higher than in the UK. For example, the price of insulin in the US is on average paying around $60 per fill as recently as 2019 (if they had private insurance or Medicare) which would last a month.
Previously touched on before is the quality of care received, in the UK the NHS standards are often praised for having excellent primary care (provided by General Practitioners, dentists, pharmacists etc) with further points of contact such as secondary (hospitals or other more specialised care facilities) and tertiary care (highly specialised treatments) being able to be referred to by the initial point of contact. The process of being referred to secondary or tertiary care is not complicated but receiving the care is difficult due to exceptionally long queues for example the waiting-list to receive braces can be up to 5 years depending on location of the patient. This greatly affects patient satisfaction and the effectiveness of the procedure as some impacted cases can be time sensitive. This issue regarding queues to receive care is one that has been gradually increasing and has been the talking point of many even being brought up to be a potential swaying point in the most recent elections where Labour prevailed and now Prime Minister Keir Starmer having pledged to drawing up a 10-year plan to save the NHS from the critical pressure it is now facing. On a sidenote the mounting pressure faced by GPs caused by COVID, the pressure has been and is continuing to be alleviated by pharmacists, taking on more consultations and more walk-ins furthermore, plans for pharmacy’s to get more funding and increase the number of consultation rooms and active pharmacists working at the same time has been in the works for the past few years. If this goes to plan the GP can have some strain released and be able to work at optimal rates, funding Is required to make this ‘dream’ a reality and alterations to university courses for Pharmacists of the future have already taken place so upon graduation pharmacists are now qualified dispensers (instead of having to do an additional top up course post-graduation) as clinical pharmacists are also involved in the primary care of patients this link with GPs is already present and would be strengthened making them more integrated.
Contrastingly in the US despite having cutting edge medical technology, it is dependent on the quality of your insurance which determines the quality of treatment an individual and it is very likely that specific procedures which would often be provided by secondary or tertiary points of contact in the UK, such as braces, would be expensive in comparison. Using the example provided the cost to get braces in the UK is free given that the patient is under 18 and most patients who get braces are in age range of 12-18 due to being able to regularly visit the dentist free of charge and being able to spot if they require braces to then be referred to the orthodontist (secondary care) where they would more than likely receive braces before the age of 18. In the case that someone over the age of 18 would need braces and didn’t have any exemptions they would be likely to be charged around £2500 privately (this can be higher depending on the private centre providing the service). In the US, braces cost around $5000-10000 depending on the type and insurance mainly covers children receiving braces but rarely provides the option for adults, making it a much higher out of pocket cost in both cases of children and adults even if they have insurance in the US.
Healthcare outcomes in the UK from data collected between 2020-2022 have found that the average male life expectancy is 78.8 years and female life expectancy is 82.8 years. This coupled with the fact of having lower preventable hospitalisations than the US point to being in a better health status as a nation common issues between the UK and the US such obesity concerns are similar.
Life expectancy from data collected in 2022 states that for males in the US it is 77.5 years and for females is at 82.2 years meaning that on average life expectancy is lower in the US than the UK despite having higher spending on healthcare per capita than any other country, the lack of consistent and affordable healthcare with socioeconomic disparities means that not only is the life expectancy lower but the quality is worse and often less likely to reach the proposed life expectancy.
To conclude, the NHS provides a much better standing for healthcare in comparison to the system in place in the US, however it has invited a lot of pressure despite being funded by taxation rather than private funding, the heavy use of it and lack of suitable/outdated infrastructure has made the increasing load hard to handle. This has got to the extent where drafts of short- and long-term solutions have been announced to be in the works to calm the public’s concerns with the previous selection Prime Ministers spanning the last 2 decades have had to address the situation and even used it in their campaigns to sway the votes in their favour. The US has high spending in the healthcare department and excellent technology for healthcare, but the entry point is difficult to navigate and anything without insurance is extremely expensive and even with insurance a lot of healthcare is out of reach, the system lacks efficiency and is complex with high administrative costs. The issues of both the UK and US appear to be contrast and are almost perfectly as opposite as it could get, on one hand the UK has a great system which has been in place for decades and is only being shaken up by the pressure placed on it by funding and the population, whilst on the other hand the US has all the funding and is not crumbling due to financial constrain or population pressure rather the system being over-complex and inefficient making it difficult for people to access it alongside being expensive and almost inaccessible to those worse off in the socioeconomic scale.